Provider Demographics
NPI:1407874530
Name:MURPHY, PATRICIA JO (ARNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:JO
Last Name:MURPHY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19423 74TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5065
Mailing Address - Country:US
Mailing Address - Phone:425-775-9318
Mailing Address - Fax:
Practice Address - Street 1:6505 218TH ST SW STE 9
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2135
Practice Address - Country:US
Practice Address - Phone:206-491-2259
Practice Address - Fax:206-365-0872
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00071430364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP552WAMedicaid
MT4301425Medicaid
WA9638560Medicaid
ID806635900Medicaid
AKNP552WAMedicaid